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shift work, arrangement of working hours that differs from the standard daylight working hours (i.e., 8:00 am to 5:00 pm). Organizations that adopt shift work schedules extend their normal working hours beyond the standard eight-hour shifts by using successive teams of workers. Notable examples of organizations that adopt shift work schedules include hospitals, fire stations, and police stations. However, forces such as industrialization, new technologies, and the globalized economy have contributed to the creation of a society that operates 24 hours a day. This 24-hour society has led to an increase in the need for shift work in other industries as well.

Types of shift work

Organizations may structure shift work in a variety of ways, depending on their needs. One organization may adopt two 12-hour shifts, whereas another may adopt three 8-hour shifts. Shift work systems can also differ in the direction and speed of shift rotation. Shift systems that rotate employee schedules from morning shifts to evening shifts to night shifts have a forward rotation, whereas shifts that rotate counterclockwise (i.e., night to evening to morning) have a backward rotation. With regard to the speed of rotation, shift systems fall into three major categories: (a) permanent shift systems (e.g., permanent night shift); (b) slowly rotating shift systems (e.g., weekly rotating); and (c) rapidly rotating shift systems (e.g., an employee works the morning shift on Monday, the evening shift on Tuesday and Wednesday, and the night shift on Thursday and Friday).

Detrimental effects

Although shift systems remain popular with employees on the front end because they provide a degree of flexibility, research investigating shift work has found that such schedules have primarily negative effects for both individuals and organizations.

Effects on psychological and physical health

Most of the early work on the psychological outcomes of shift work focused on the exploration of shift workers’ attitudes, such as job satisfaction. This research suggests that, although workers welcome the idea of shift systems up front, they are typically less satisfied with their work than nonshift workers. Additionally, the research shows that psychological and emotional distress accompanies shift work. However, studies on the severity of these issues have not been conclusive.

A great deal of research has investigated the impact of shift work on individual circadian rhythms. Humans have evolved over thousands of years as a species that habitually sleeps during the night and is awake during the day. The rotation of Earth around the sun creates a 24-hour cycle of light and dark, which is internalized by humans and forms a natural internal body clock. All human circadian rhythms normally show a fixed-phase relationship. For example, body temperature peaks in the evening. In general, many bodily functions are at their highest level of activity during the day, allowing for a natural progression toward sleep at night.

Sleep problems occur for shift workers as a result of the mismatch between environmental time cues and the internal timing system. Although the natural light-dark cycle, the clock time, and other social cues may remain the same, the timing of shift workers’ work and sleep is delayed. Evidence suggests that adjustments to the shift workers’ body clocks are slow, if they occur at all. This mismatch between the environment and the internal body clock has been linked to negative outcomes such as sleep deprivation and chronic fatigue.

Chronic fatigue is linked with greater incidence of physical injury. A greater number of serious job-related injuries occur among employees who work night shifts. Night shift workers are more likely to be involved in automobile accidents on the drive home from work than day shift workers. While the link between work hours and increased risk of injury seems clear, several potential confounding factors must be considered for injuries sustained on the job. Significantly, night shift workers are often less experienced and work with less supervision than their daytime counterparts.

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By far the most prevalent health complaint associated with shift work is gastrointestinal problems. Irregular eating schedules and diminished access to healthful foods may in part account for this. The relationship between cardiovascular disease and shift work has also been explored. Many characteristics of shift workers are considered predictors of cardiovascular disease (e.g., poor eating habits, gastrointestinal disorders, sleeping disorders, less favorable working conditions). Shift work has additionally been shown to have negative effects on the reproductive cycles of women (e.g., increased menstrual pain and fertility problems). The physiological effects of shift work may also influence drug activity and effectiveness, suggesting that persistent shift work may be incompatible with the efficacious treatment of disease.

Social and domestic disruption

In addition to the psychological and physical effects, shift work is related to several social and domestic variables. For example, although organizations may believe that it is advantageous to operate on a 24-hour schedule, estimates place the cost of shift work among U.S. companies at tens of billions of dollars a year. Research has shown higher rates of absenteeism among shift working populations. Thus, the cost results in part from lost productivity because of absenteeism and higher medical bills because of increased injury and accidents. Additionally, shift work is associated with a decreased ability to balance work and nonwork responsibilities. Divorce rates for shift workers are substantially higher than those for day workers.

Variables among individual shift workers

Several individual difference variables have been shown to be important to the relationship between shift work schedules and outcomes. For example, “morningness,” or a preference for going to bed early and rising early in the morning, is moderately associated with difficulty adjusting to night work. Additionally, sleep flexibility (i.e., the ability to sleep at unusual times) and vigor (i.e., the ability to overcome drowsiness) predict an individual’s level of tolerance for shift work.

Individual differences in age and personality are also frequently investigated. The older an employee is, the less tolerance he or she will have for shift work. It has been recommended that shift work be voluntary after the age of 40. Over the age of 50, it becomes increasingly difficult for individuals to alter their sleep-wake cycles. Many physical ailments increase with advancing age, and this increase in physical problems affects older individuals’ ability to adjust to shift work. With regard to personality, it has been found that introverts are generally more morning-oriented than extroverts, making it more difficult for them to adjust to shift work.

Another individual difference variable that has been explored is the amount of social support an individual receives. Supervisor support has been found to be a crucial buffer to the negative effects of stress induced by shift work.

Assessment

Research suggests that shift work has negative effects for individuals, organizations, and society. These effects are many and serious. However, for some organizations, shift work is a necessity. Research on the design of a shift work system that is minimally detrimental to employees is ongoing.

One review of shift systems produced five general recommendations regarding the design of shift work systems. First, it seems that night work should be reduced as much as possible. If this is not possible, an organization should adopt a rapidly rotating system. Second, long shifts (e.g., 9 to 12 hours) should be avoided. Third, flexible work arrangements should be integrated with shift systems. Fourth, shift changes within the same day should be avoided, and the number of consecutive days worked should be limited. The final recommendation suggests that forward rotation is most preferable.

Boris B. Baltes Lindsey M. Young

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Mini-stroke patients may experience fatigue for up to a year May 15, 2025, 7:17 AM ET (News-Medical)

fatigue, specific form of human inadequacy in which the individual experiences an aversion to exertion and feels unable to carry on. Such feelings may be generated by muscular effort; exhaustion of the energy supply to the muscles of the body, however, is not an invariable precursor. Feelings of fatigue may also stem from pain, anxiety, fear, or boredom. In the latter cases, muscle function commonly is unimpaired.

The once-held belief that work was the cause of fatigue led to efforts to use the work output of factory workers, for example, as direct measures of fatigue. Early studies by industrial psychologists and engineers failed to show a close connection between how an individual worker said he felt and the amount of work he accomplished; production-oriented investigators were even led to attribute no significance at all to inner feelings of fatigue, and their attention shifted from the inner condition of the worker to external phenomena not related to the worker at all. In the process it was forgotten that work output is a product of, rather than a description of, the worker.

For other researchers who retained an interest in the worker himself, study was typically directed to observable body processes rather than to the overall internal state of the worker as manifested in how he said he felt. Such studies disclosed, among other things, that oxygen and glucose were consumed during work and that waste products such as carbon dioxide and uric acid were produced. Hence, for some investigators fatigue came to mean a bodily state in which waste products were present in high concentration.

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muscle disease: Fatigue

All such studies clearly revealed specific results of exertion and disclosed evidence for the burning of food materials (metabolites); taken by themselves, the data provided a picture of the human organism as an energy-converting system and showed a definite relation of this process to energetic (work) performance. Such studies are a part of basic physiological research and apply most closely to what may be expected of people under heavy exertion in the workaday world and in sports and athletics.

Feelings and other signs of fatigue can arise suddenly and disappear suddenly, and the onset, duration, and termination of fatigue symptoms may appear to bear little relation to exertion or work. When fatigue arises in nonexertional situations, there is a temptation simply to say that the fatigue is “psychological” or “motivational.” Relatively little research has been devoted to fatigue as descriptive of the person himself and of the full range of demands he has to meet, although many of these demands lie outside the simple energy requirements of more-or-less arduous work.

Man is able to—and may—respond to any situation in more than one way and at more than one level of behavioral complexity. The most readily observable ways are grossly physical and chemical; but these, in turn, underlie other levels of response such as primitive sensory activity (becoming aware of stimuli), and still higher levels such as perceiving (e.g., evaluating the nature and objectives of work activity). At the highest level of activity the relationship often is spoken of as existing between the whole person and the environment.

Since most investigative attention in industrial or other production situations has been directed toward what man can do in terms of his being only a machine that converts food energy into useful work, an understanding of the fine details of the relation between fatigue and physiological body processes has preceded experimental efforts to specify the role of personal attitudes (such as the individual’s own evaluation of his abilities). Such self-evaluations (e.g., a worker’s judgment that he cannot continue activity) rather than any exhaustion of the energy available within the body result in the termination of activity. Often when such changes in performance are attributed to motivation, or to any of a number of factors called psychological, one’s allegiance to ancient views of the nature of man may tempt him to think of mental factors disjoined and unrelated to any physical, energistic description of the organism. Yet, a fully useful definition of fatigue would require that all relevant factors be considered. Indeed, modern efforts to achieve a unified, integrated definition of fatigue rest on studies in which higher-order mental processes (such as thinking, perceiving, and emoting) are investigated to find whether they seem to stem from physical body processes.

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Fatigue as it is applied to the whole person involves an individual’s feelings of discomfort and aversion, his inner awareness of making mistakes, and any changes in observable signs of effort required to carry on the performance involved. These aspects are found to be related in various ways to measurable variations in work output. Investigators who typically focus primarily on work output are apt to be concerned with the applied, practical view of the person as a productive worker; interest is more likely to be concentrated upon the worker himself by those scientists who wish to study fatigue even if their findings are not directly productive of work output. The worker himself is interested in how he feels and what makes him feel as he does.

At any rate, in accounting for fatigue, it is useful to make distinctions between what pertains to the individual as a whole and what pertains only to some part or organ of the individual. That the total behaviour is spoken of as personalistic, or psychological, is not simply because self-awareness (inner feeling of fatigue) is involved but because, at this level, resources are directed toward ends that go beyond the limited function of any one body part. This situation is illustrated by a simple example in muscular activity. When muscle activity is described in itself (at a given subpersonalistic level), it is simply called muscle contraction. Muscle contraction occurring as an integrated part of more complex personalistic behaviour may be called reaching; this action is an integral part of grasping a pencil, which is part of the more personalistic act of writing to one’s friends.

While fatigue is one consequence of grossly observable activity, it can occur in the absence of manifest muscular exertion. It can develop, for example, as a rather immediate response to a socially exercised demand (such as that of a nagging supervisor), of which the person suddenly becomes aware but may not like. The feeling of fatigue produced in the absence of productive work seems to be essentially the same as that produced by goal-directed labour. Some components nevertheless are different, such as aching muscles in the one case and not in the other, but the factors that give fatigue its identity and differentiate it from other states of inadequacy are present in both. In each case conditions exist that can even result in one’s total inability to carry on, whether his muscles contain high concentrations of waste products or not.

Muscular exertion does, however, produce biochemical changes in the body that are quite complex and that differ in various tissues and organs such as the heart or the brain. The consequence almost invariably is to produce secondary effects, perhaps muscular stiffness, and these in turn give rise to higher level effects such as one’s sensory awareness of pain and discomfort. At a more personalistic level, the individual may develop a change in attitude with regard to the task or activity in progress; e.g., he may begin to feel aversion for the work. The whole process, in effect, yields the individual’s self-generated assessment of his own ability to carry on. If he continues his exertions under his personal assessment that such activity will produce more pain or will become more nearly intolerable or even impossible, the anticipated consequences include less efficient work performance. As the worker becomes preoccupied with his discomfort and with his waning production, the effect typically is to produce still more inefficient work. Thus fatigue defined as muscular inability to carry on and fatigue defined as a kind of felt aversion for exertion and as feelings of inability to carry on are all produced.

Performance may be observed to deteriorate (among factory workers, for example) even when there are no signs of the feeling state and of the aversive, pessimistic self-assessment defined here as personalistic fatigue. Indeed, often enough one may be “fatigued” without knowing it, indicating the predominance of relatively subpersonalistic factors at work. Such factors can be lumped under the term impairment, mentioned originally as one of the major forms of human inadequacy. While transient impairment and personalistic fatigue generally have not been distinguished from each other by many psychologists, in numerous studies impairment, rather than the feeling of fatigue, has been the point of interest.

Impairment of this sort reflects alterations in the chemical processes that occur within the cells of the body. That the alterations are reversible is illustrated in alcohol intoxication and oxygen lack (hypoxia). When such transient impairment incapacitates the individual for energetic activities without greatly affecting his brain processes, he is likely to feel tired and weak. Thus, it can be said that transient physiological impairment and personalistic fatigue are closely related, one being a basis for the other. When brain processes are so sharply affected as to reduce perceptual or attitudinal awareness, impairment may produce marked behavioral consequences without associated feelings of fatigue. In such cases, feelings of weakness and tiredness may not be reported by the individual since his abilities for self-evaluation have been dulled.

The failure of people to have feelings of fatigue as a consequence of physiological impairment is characteristic of some forms of hypoxia, which can be brought on in several ways. One of these is by a fairly abrupt reduction in atmospheric oxygen pressure, as would occur in one’s being deposited atop a mountain by helicopter. Feelings of fatigue are much more likely to set in when oxygen reduction is gradual and associated with exertion (as in mountain climbing). Along with lack of oxygen, other factors of the climber’s task play their roles, and the climber’s own awareness of the negative factors that are developing produces the full syndrome of fatigue, including both the inability to carry on and the aversive attitude.

In contrast to this, oxygen lack can be produced much more quickly in a decompression chamber in a laboratory, without any associated muscular exertion. It is possible to reach levels of hypoxia that abruptly reduce the subject’s efficiency in exercising self-assessment, and personalistic fatigue in such cases fails to develop.

This article was most recently revised and updated by Michele Metych.